Side-effects of drugs in epileptic patients |
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Authors: | A Keyser Y A Hekster E Termond A Theeuwes M Schaap and H T Rwiza |
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Institution: | (1) Institute of Neurology, University Hospital Nijmegen, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands;(2) Department of Clinical Pharmacy, University Hospital Nijmegen, the Netherlands;(3) Department of Medical Statistics, Faculty of Science, Catholic University of Nijmegen, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands |
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Abstract: | Drug therapy in patients suffering from various forms of epilepsy aims at the administration of such dosages of antiepileptic drugs as to produce significant reduction of seizures without the occurrence of serious side-effects. To assess these side-effects 75 patients (48 males, 27 females) with epilepsy, attending an out-patient clinic were studied prospectively and data were collected regarding diagnosis, drug use and side-effects. Primarily generalized epilepsy and partial complex epilepsy with secondary generalization are the most prevailing categories. 69% (52) Of the patients are treated with monotherapy, with carbamazepine as the drug most frequently prescribed (30/52). Side-effects were scored after examining and questioning the patient with the help of a standard questionnaire. A distinction was made between groups of side-effects, being systemic, anamnestic, dermatological, neurological or miscellaneous. Also, haematological and biochemical changes were looked for. In the monotherapy group 26/52 (50%) of the patients showed side-effects (23 patients with 1, 2 with 2, 1 with 3 side-effects), and in the polytherapy group 15/23 (65%) (8 patients with 1, 7 with 2 side-effects). Adverse drug reactions were hardly related to the plasma concentration category. Between 50–60% of the patients at sub-therapeutic and low-therapeutic plasma levels complained of side-effects. No clear relationship between the clinical efficacy and the side-effects could be established. The clinical custom, among others, to titrate the dose according to the disappearance or appearance of side-effects seems open for discussion. |
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Keywords: | Anticonvulsants Clinical trials Serum levels Side-effects |
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